1. Field of the Invention
The present invention relates generally to a knee resurfacing prosthesis and more specifically it relates to a bicondylar knee resurfacing prosthesis for bicompartmental knee resurfacing, which is inserted through a limited and minimally invasive lateral approach, without any disruption of the extensor mechanism or damage to the quadriceps tendon.
2. Description of the Related Art
It can be appreciated that knee-resurfacing prostheses have been in use for years to treat articular surfaces destroyed by arthritis or pathological processes secondary to trauma. Basically, the natural knee joint comprises an upper femoral articular surface having two condylar surfaces and a lower tibial plateau comprising two cupules shaped tibial condyles articulating smoothly with the upper femoral condyles. Typically, knee replacement prostheses are comprised of several types of prostheses, where articular compartments of the knee are removed and replaced with metal and polyethylene components.
The devices of prior art attempted to duplicate the geometry of the natural articular surface, where the femoral component have a semicircular C shaped device such as depicted in a U.S. Pat. No. 4,224,696. The bicondylar design is similarly disclosed in prior patents by F. Buechel and Pappas in U.S. Pat. Nos. 4,309,778 and 4,470,158. More recent bicondylar design is described in U.S. Pat. No. D473,307S and U.S. Pat. No. 6,197,064 B1. The prior art describes the bicondylar prosthesis as having a middle patellar groove for the femoral patellar articulation. Other knee resurfacing devices are used to resurface only one femoral condyle such as unicondylar prostheses described in U.S. Pat. No. 7,141,053; U.S. U.S. Pat. No. 6,726,724B2,
Most unicondylar devices used septum, pegs and alike for fixation. The unicondylar design as described in U.S. Pat. No. 6,299,645 B1 used multiple dovetail pegs for fixation to one femoral condyle.
However, unicondylar prostheses in general present a high rate of failure due to loosening and dislocation secondary to poor distribution of weight and high concentration of stress over a small surface. Furthermore, almost all the patents cited above described prostheses that are inserted through a conventional anterior, anteromedial or anterolateral surgical approach.
The main problem with conventional knee resurfacing prostheses is the fact that the surgical approach used during their insertion causes extensive soft tissue disruption and irreparable scarring to major anatomical structures. Another problem with conventional knee resurfacing prostheses is the anterior surgical approach that violates the extensor mechanism of the knee joint, namely, the quadriceps muscle, quadriceps tendon and the medial extensor retinaculum. Another problem with conventional knee resurfacing prostheses is the need to laterally dislocate and “flip over” the patella and the patellar tendon in order to access both condyles, which frequently weakens the insertion of the patellar tendon, causing undue pain in the immediate post operative period.
While these devices may be suitable for the particular purpose to which they address, they are, because of their size, not suitable for bicondylar knee resurfacing through a limited lateral approach, without disrupting the extensor mechanism or damaging the quadriceps tendon. The main problem with conventional knee resurfacing prostheses is the fact that both condyles are approached anteriorly through a medial or lateral para patellar approach, which causes extensive soft tissue disruption and irreparable scarring to major anatomical structures by violating the extensor mechanism of the knee joint, namely, the quadriceps muscle and tendon.
Another problem is the large size of the femoral component of the conventional prosthesis, which makes it very difficult to insert through a limited true lateral approach that is appropriately described for the prosthesis of this invention. The prosthesis of this invention is thinner and much smaller than the conventional total knee femoral component, since it does not address the femoro-patellar joint.
In these respects, the bicondylar knee resurfacing prosthesis according to the present invention substantially departs from the conventional concepts and designs of the prior art, and in so doing provides an apparatus primarily developed for the purpose of resurfacing the articular surfaces of the femur and the tibia through a limited and true lateral approach, without disruption of the extensor mechanism or damage to the quadriceps tendon. Furthermore, the prosthesis of the present invention does not address the patello femoral joint such as other conventional devices and hence, is much thinner and smaller in size.